Lee County EMS contract dispute: MedEx challenges, FirstHealth defends

On Oct. 6, Lee County Commissioners heard grievances about the EMS franchise award.

Lee County is required by state law to provide emergency medical services and to hold a public hearing before granting an EMS franchise. The county has contracted with outside ambulance providers since 1997, with its current agreement with FirstHealth of the Carolinas set to expire in June 2026.

After reviewing new vendor applications, the EMS Advisory Committee recommended Lee County continue its partnership with FirstHealth.

Since 2021, FirstHealth of the Carolinas has had the contract to provide Emergency Medical Services in Lee County. It expires Sept. 30, 2026.

Founded in 2010, MedEx Medical Transport Service is North Carolina’s largest private ambulance provider, operating in 13 counties across the state.

MedEx’s application shared on the county website on Sept.18, states they expanded rapidly by focusing on patient care, modern equipment, and competitive employee compensation. MedEx serves major hospital systems, VA centers, and military facilities, combining statewide resources with locally managed operations that address community needs.

MedEx’s Chief Operations Officer, Jeff White, spoke on behalf of the company Oct. 6 and during the first of two EMS bid presentations. He raised concerns about how the advisory board handled the bid process. He said applications were assessed inconsistently across multiple meetings since June, due to miscommunication.

“We were told the board should not consider costs when making recommendations…During one of the meetings, there was a break called and it [the meeting] abruptly stopped after that,” White said about transparency concerns because voting must be public, but the company was instead given a letter of the board’s decision.

Commissioners said they heard no complaints from the advisory board about how meetings were held.

“MedEx’s bid was approximately twelve-million dollars less,” White said about saving taxpayers money.

White furthered his argument in sharing staff was not inexperienced and answered 330,000 calls in the last five years, and MedEx is the only private organization honored by the state to have its own teaching institution ranking with community colleges.

White said the advisory board exposed transparency issues: receiving pre-recorded spoken statements instead of direct communication, and a missing form required for their formal bid submission. White warned that these problems could result in higher costs and lower-quality service for Lee County residents, and he formally requested the board redo the bid process to ensure all solicitations are reviewed fairly.

There was a noticeable shift in the atmosphere, resulting in confusion among the commissioners, who seemed unsure how to address White’s concerns.

FirstHealth representatives presented during the public hearing. Jonathan Davis, Chief Operating Officer of FirstHealth of the Carolinas and president of Moore Regional Hospital, outlined the company’s current services, including 24/7 on-call fleet maintenance and full equipment support.

Matt Prestwood of Moore Regional Hospital over EMS presented data showing FirstHealth has invested $1.7 million in Lee County during the current contract period, including new trucks and mobile data terminals. He reported an average response time of nine minutes and noted Central Carolina Hospital accounted for 5,131 transports during the contract period. FirstHealth also operates a First Responder Program in partnership with the Sanford Fire Department.

“Not only do we serve this county, we are a part of this county,” Prestwood said, affirming his foundational relationship with Lee County.

Mickey Foster, FirstHealth CEO, strengthened the keeping it in the neighborhood ideology, saying he was born and raised in Lee County.

During the public comments on the ordinance, several speakers shared personal and professional experiences praising FirstHealth’s EMS services in Lee County.

Sanford resident Theresa Tudor, 77, highlighted the life-saving care she received during a severe allergic reaction and said the quick, skilled response gives seniors peace of mind and a better quality of life.

ER physician Nathan Miller emphasized FirstHealth’s commitment to high-quality patient care, ongoing staff training, and top performance in national rankings.

Matthew McBryde, a paramedic supervisor at FirstHealth for Lee County, said FirstHealth’s long-term investment in local EMS includes a paramedic academy, wage increases, and community-focused initiatives, calling the company a reliable partner for safety and workforce stability.

Sanford Resident David Smoak raised questions regarding the allegations of unfair treatment mentioned by White. Smoak shared his experience working with military and federal contracts, adding credibility to his statement.

“Potential issues in the bidding process should be noted, and discrepancies should be investigated if they are found. If these concerns are not being addressed, that would concern me,” Smoak said, emphasizing the need for transparency and accountability.

MedEx did not reply to Sandhills News’ multiple statement requests.

Lee County administrative staff did not respond to inquiries.

The ordinance must pass during two consecutive board meetings before the franchise can be awarded. The next Lee County Board of Commissioners meeting is Oct. 20, at 6 p.m. at the Dennis Wicker Civic Center.

Oct. 16, 2025

Diara J. Townes

Engagement Journalist

Diara is an award-winning journalist covering environment, government and business, with a focus on marginalized communities and local stories.

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